Abouzahir A, Bennouk Y, El Qatni M, El Omri N, Hammi S, Badaoui M, Mekouar F, Fatihi J, Sekkach Y, Amezyane T, Ghafir D, Echachoui H
Service de médecine interne B, hôpital militaire d'instruction Mohammed V, 10000 Riad, Rabat, Maroc.
J Fr Ophtalmol. 2012 Nov;35(9):724.e1-5. doi: 10.1016/j.jfo.2011.12.008. Epub 2012 Sep 13.
Polyarteritis nodosa (PAN) is a systemic vasculitis with polymorphic manifestations. Ocular involvement is rare; we report two such cases.
The first case was a 56-year-old man with PAN treated with corticosteroids. A year and a half later, during a disease outbreak associated with decreased visual acuity, ocular examination objectified a localized pigment epithelial detachment in the right eye. The outcome was favorable with corticoid bolus followed by azathioprine. The second case was a 41-year-old man presenting with PAN and decreased visual acuity. Ophthalmologic examination showed inferotemporal branch vein occlusion in the right eye with serous retinal detachments in the left eye. The outcome was favorable with intravenous cyclophosphamide followed by azathioprine.
The incidence of ocular involvement in PAN varies from 10 to 20%. It is most often associated with vasculitis of retinal and choroidal arteries. Fluorescein angiography is the gold standard of diagnosis. Multifocal acute ischemia of the choriocapillaris is very pathognomonic. Immunosuppressant drugs are effective and should be reserved for severe forms.
结节性多动脉炎（PAN）是一种具有多种表现形式的系统性血管炎。眼部受累较为罕见；我们报告两例此类病例。
第一例是一名56岁接受皮质类固醇治疗的PAN男性患者。一年半后，在一次与视力下降相关的疾病发作期间，眼部检查发现右眼有局限性色素上皮脱离。给予大剂量皮质类固醇随后使用硫唑嘌呤治疗，结果良好。第二例是一名41岁患有PAN且视力下降的男性患者。眼科检查显示右眼颞下分支静脉阻塞，左眼有浆液性视网膜脱离。给予静脉注射环磷酰胺随后使用硫唑嘌呤治疗，结果良好。
PAN眼部受累的发生率在10%至20%之间。最常与视网膜和脉络膜动脉的血管炎相关。荧光素血管造影是诊断的金标准。脉络膜毛细血管多灶性急性缺血具有很强的诊断特异性。免疫抑制药物有效，应仅用于严重病例。
